Discover and read the best of Twitter Threads about #blooducation

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These are the lungs of a patient who died while receiving a PLT transfusion. He developed sudden respiratory distress and did not respond to O2 support. Lungs compressed by 3000 mL of transudative pleural fluid. Notice the increased neutrophils #PathTweetorial
The above clinical scenario along with the histologic findings is consistent with which type of transfusion reaction?
#Blooducation #TransfusionReaction
Yes, the histologic findings and clinical history is consistent with Transfusion-Related Acute Lung Injury (TRALI). Second to TACO, it is the most common cause of transfusion-related morbidities and fatalities. What causes it?
Read 11 tweets
Inspired by @BenMazer and the topic of #platelet #transfusion in #cerebralhemorrhage patients previously taking anti-platelet therapy, I want to take a few minutes to talk about the EVIDENCE in platelet transfusion indications, thresholds, and efficacy. #blooducation
To recap, the PATCH trial (Lancet 2016) concluded that in patients taking anti-platelet medications (aspirin, plavix, etc) who had spontaneous cerebral hemorrhage, platelet transfusion was assc with WORSE outcomes than standard medical therapy.
This is shocking? Right? Here's the classic logic:
-ICH is bad
-ICH is worse if your platelets are iatrogenically broken
-Non-broken platelets are good
-Transfusion of non-broken platelets helps stop the bad bleed
Read 26 tweets
62 y/o man, O positive with de novo AML undergoes workup for Hematopoietic Stem Cell Transplant (HSCT). 😃Good news: Sibling with 8/8 HLA match! 👎🏽Bad news: Sibling is A positive. Can this sibling be a donor?
#Blooducation #PathTweetorial #HSCT
Unlike solid organ transplants, ABO-mismatch HSCT is not a barrier. In fact, 25-50% of all HSCT are ABO-incompatible. The most important factor in transplant survival outcomes is HLA compatibility (Chrom. 6p)
✅Critical to engraftment
✅ Balances potential harm of GVHD vs GVL
ABO carbohydrate glycosyltransferases are genes located on chromosome 9 and inherited completed independent of HLA. ABO Ags are not only on RBC membranes, but are also expressed on PLTs, vascular and organ endothelium as well as present in the plasma.
Read 12 tweets

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